From Power to Empowerment: paradigm shift in leadership

Helen Connors, PhD, RN, FAAN, ANEFUniversity of Kansas, School of Nursing

and Center for Health Informatics

Objectives

• Discuss a historical review of nurses’ power• Describe the kinds of power nurses need for

optimum impact• Create a culture of empowerment

Looking Back to Improve the Future

Mother of Modern NursingIn attempting to arrive at the truth, I have applied everywhere for information, but in scarcely an instance have I been able to obtain hospital records fit for any purposes of comparison. If they could be obtained they would enable us to decide many other questions besides the ones alluded to. They would show the subscribers how their money was being spent, what amount of good was really being done with it, or whether the money was not doing mischief rather than good.”Florence Nightingale (1863).

Longman, Green, Longman, Roberts and Green: Notes on Hospitals, 1863, London, p. 176First Nurse Informatician

Lillian Wald & Mary Breckenridge

Power

• Having control, influence, or domination over something or someone.

• The ability to get things done, to mobilize resources, to get and use whatever is needed to meet one’s goals.

• Includes - caring practices by nurses which are used to empower patients (Benner, 2001).

Putting Nurse’s Power in Context

• Social and Cultural – Women’s work– Domestic role– Done in private

• Educational– Taught in hospitals– By physicians– Multiple entry levels

Multiple Levels of Power• Macro-level: systems,

organizational, societal – Professional associations– Nursing schools

• Meso-level: Power also operates in– City, county, state, and

institution decisions about resources and regulations

– Large bureaucratic organizations, corporations, ethnic or minority groups

• Micro-level: – Interpersonal or relational

levels

Types of Power

• Legitimate – a position of power• Informational(Expert) –comes from ones

experiences, skills, knowledge• Coercive – conveyed through fear• Referent- comes from being trusted and

respected• Charisma – power legitimized by a leader’s

exceptional characteristics

Domains of Power

• Content – ability to act according to one’s knowledge and judgement (autonomy)

• Context – control of practice/work

environment

• Competence of nursing practice- education and expertise

Power and Empowerment

Power Empowerment

Types of Empowerment

• Structural Empowerment – managerial practices

• Personal Empowerment – psychological state

Kanter RM. Men and Women of the Corporation. 2nd ed. New York, NY: BasicBooks; 1993

Structural Empowerment

• Access to resources• Access to all information to get the job done

as well as about the organization• Support for job responsibilities and decision

making• Opportunity for professional growth and

development

Kanter RM. Men and Women of the Corporation. 2nd ed. New York, NY: BasicBooks; 1993

Personal Empowerment

• Confidence in one’s own abilities• Access to power, authority and influence• Ability to make one’s own decisions• Employing your strength when dealing with

others• Having a sense of connectedness and kindness

Kanter, 1993

The Empowered Nurse

• Nurses should practice to the full extent of their education and training (transforming practice).

• Nurses should be full partners, with physicians and other health professionals, in redesigning health care (transforming leadership)

• What does an empowered nurse look like?

(IOM, The Future of Nursing: Leading change, advancing health, 2010)

The Empowered Student

• Nurses should achieve higher levels of education and training through improved education systems that promotes seamless academic progression (transforming education).

• How can we empower students?

(IOM, The Future of Nursing: Leading change, advancing health, 2010)

The Empowered Patient

• The public is increasingly aware that they must assume a greater role in health care issues.

• Do you think patients want to be empowered?• What do patients/consumers need to be

empowered?

Empowered Patient APP

Facts from Pew Research Center

• 87% of U.S. adults use the internet. • 72% of internet users say they looked online for

health information.• Most commonly-researched topics are specific

diseases or conditions; treatments or procedures; and doctors or other health professionals.

• 60% of U.S. adults say they track their weight, diet, or exercise routine.

http://www.pewinternet.org/fact-sheets/health-fact-sheet/

Autonomy

Competence

Mind-Mapping For use with Table Discussions

ManagementLeadership

Just Culture

Mind-Mapping For use with Table Discussions

Positive nursing image

Caring

Mind-Mapping For use with Table Discussions

Professional development

Life-long learning

Mind-Mapping For use with Table Discussions

Community outreach

Boards

Mind-Mapping For use with Table Discussions

KEY ACTIONSFirst 3 Years

Mind-Mapping For use with Table Discussion

CommunityOutreach

Prof Dev

Mange/Lead

Positive image

Autonomy

Mind-Mapping For use with Table Discussion

CommunityOutreach

Prof Dev

Mange/Lead

Positive image

Autonomy

SUCCESS FACTORS3 –Year Priorities

Group Work